AbstractsMedical & Health Science

Racial and ethnic health disparities have been well documented in the areas of pain epidemiology, access to quality pain care, pain assessment and treatments, as well as pain-related outcomes. These disparities emerge around patient-level factors, such as race, ethnicity, socioeconomic status, age and gender for all types of pain. In response to these above concerns, this study examined the sources of variance in cancer diagnosis, cancer pain prevalence, pain treatment, and treatment efficacy in an effort to identify disparate outcomes utilizing data from the multi-state 2012 Behavior Risk Factor Surveillance System (BRFSS) survey conducted by the Centers for Disease Control and Prevention. This study allowed for the ability to control for access-related factors, as well as multiple psychosocial variables such as age, income, education, gender, health care coverage, general health, etc. Moreover, this study was able to observe variations in outcomes amongst subjects with all forms of cancer, rather than selecting individuals with a single diagnosis as many other studies have done. Statistical evaluation of the BRFSS data set found that racial and ethnic minorities were significantly less likely to be diagnosed with cancer. Also, when controlling for other confounding factors, racial minority patients subsequently reported cancer-related pain a rate that was statistically higher than that reported by Caucasians. This same relationship was not statistically significant among ethnic minority patients. However, analytic evidence was not statistically significant in the rate of cancer pain treatment in accordance with subjects’ racial and ethnic identities. It instead appeared that health status was of far more predictive value in this regard. Finally, further analysis demonstrated that provision of ongoing cancer care instructions had a statistically significant positive association with the likelihood that subjects would report the receipt of effective pain medications or treatments. These findings must be accompanied by the caveat that some limitations exist regarding the extent to which findings based upon this sampling of BRFSS data may be more broadly generalized to the US population, as well as the specificity of the available data points. Despite these facts, this study has been successful in further documenting disparities in cancer diagnosis and cancer pain reporting. Both of these points warrant further investigation, perhaps with the benefit of a larger sample population and a survey instrument specifically tailored to this task, to ensure that all patients receive high quality medical care despite their racial or ethnic affiliations.